title: Cytotoxic strains of Pseudomonas aeruginosa can damage the intact corneal surface in vitro.
abstract: OBJECTIVE
  Although the corneal epithelial cell layer is believed to serve as a barrier against most types of bacteria, certain strains of P. aeruginosa have been shown to kill corneal epithelial cells in primary cultures. The aim of this study was to test whether these strains could damage epithelia on uninjured whole corneas.
  
  
  METHODS
  Five-week-old Sprague-Dawley rats were sacrificed and their eyes were placed in organ culture. The corneal surface of each eye was incubated with 8 microL of media alone or a bacterial suspension containing 8 x 10(6) cfu of one of 12 cytotoxic and noncytotoxic strains of P. aeruginosa for 3 hours at 35 degrees C. Trypan blue was then added to visualize surface epithelial cell injury. A masked observer examined each cornea under a dissecting microscope and assigned a score of between 1 and 3 to describe the extent of injury.
  
  
  RESULTS
  Cytotoxic P. aeruginosa injured the surface epithelium. The extent of injury induced by the various strains correlated with previously published in vitro measures of cytotoxic capacity toward cultured corneal epithelial cells. Cytotoxicity required at least 2 hours of bacterial contact and was dependent upon ExsA, a transcriptional activator of several genes in P. aeruginosa, including the gene encoding exoenzyme S.
  
  
  CONCLUSIONS
  Cytotoxic P. aeruginosa strains can damage epithelia on an uninjured corneal surface providing there is prolonged bacterial contact. Stagnation of cytotoxic bacteria against the corneal surface may contribute to the pathogenesis of infection associated with the use of soft contact lenses.
authors.affiliation: Sarver Laboratory for Cornea and Contact Lens Research, School of Optometry, University of California, Berkeley 94720-2020, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Fleiszig
authors.forename: E J
authors.initials: EJ
authors.lastname: Lee
authors.forename: C
authors.initials: C
authors.lastname: Wu
authors.forename: R C
authors.initials: RC
authors.lastname: Andika
authors.forename: V
authors.initials: V
authors.lastname: Vallas
authors.forename: M
authors.initials: M
authors.lastname: Portoles
authors.forename: D W
authors.initials: DW
authors.lastname: Frank
mesh_terms: D000818:Animals; D001426:Bacterial Proteins / Q000235:genetics; D016923:Cell Death; D004268:DNA-Binding Proteins / Q000235:genetics; D019573:Epithelium, Corneal / Q000382:microbiology / Q000648:ultrastructure*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000473:pathology*; D005798:Genes, Bacterial / Q000235:genetics; D006801:Humans; D007634:Keratitis / Q000382:microbiology / Q000473:pathology*; D008855:Microscopy, Electron, Scanning; D009924:Organ Culture Techniques; D011552:Pseudomonas Infections / Q000382:microbiology / Q000473:pathology*; D011550:Pseudomonas aeruginosa / Q000235:genetics / Q000502:physiology*; D011817:Rabbits; D051381:Rats; D017207:Rats, Sprague-Dawley; D015534:Trans-Activators / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D004268:DNA-Binding Proteins; C095092:ExsA protein, bacteria; D015534:Trans-Activators